Adamantane- and Oseltamivir-Resistant Seasonal A (H1N1) and Pandemic A (H1N1) 2009 Influenza Viruses in Guangdong, China, during 2008 and 2009

Zhou, Jie; Zou, Lirong; Zhang, Xin; Liao, Jiazheng; Ni, Hanzhong; Hou, Nianmei; Wang, Yajing; Li, Hui; Wu, Jie; Jonges, Marcel; Meijer, Adam; Ke, Changwen

doi:10.1128/jcm.00535-11

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…Our data revealed the disproportional levels of amantadine resistance observed in H5N1 viruses and human seasonal H3N2 and H1N1pdm09 viruses in recent years (Deybe et al, 2007; Zaraket et al 2010; Zhou et al, 2011). Importantly, the susceptibility of H5N1 influenza viruses to amantadine has increased in recent years (2010–2012).…”

Section: Discussionmentioning

confidence: 63%

Antiviral resistance among highly pathogenic influenza A (H5N1) viruses isolated worldwide in 2002–2012 shows need for continued monitoring

et al. 2013

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Highly pathogenic (HP) H5N1 influenza viruses are evolving pathogens with the potential to cause sustained human-to-human transmission and pandemic virus spread. Specific antiviral drugs can play an important role in the early stages of a pandemic, but the emergence of drug-resistant variants can limit control options. The available data on the susceptibility of HP H5N1 influenza viruses to neuraminidase (NA) inhibitors and adamantanes is scarce, and there is no extensive analysis. Here, we systematically examined the prevalence of NA inhibitor and adamantane resistance among HP H5N1 influenza viruses that circulated worldwide during 2002–2012. The phenotypic fluorescence-based assay showed that both human and avian HP H5N1 viruses are susceptible to NA inhibitors oseltamivir and zanamivir with little variability over time and ~5.5-fold less susceptibility to oseltamivir of viruses of hemagglutinin (HA) clade 2 than of clade 1. Analysis of available sequence data revealed a low incidence of NA inhibitor–resistant variants. The established markers of NA inhibitor resistance (E119A, H274Y, and N294S, N2 numbering) were found in 2.4% of human and 0.8% of avian isolates, and the markers of reduced susceptibility (I117V, K150N, I222V/T/K, and S246N) were found in 0.8% of human and 2.9 % of avian isolates. The frequency of amantadine-resistant variants was higher among human (62.2%) than avian (31.6%) viruses with disproportionate distribution among different HA clades. As in human isolates, avian H5N1 viruses carry double L26I and S31N M2 mutations more often than a single S31N mutation. Overall, both human and avian HP H5N1 influenza viruses are susceptible to NA inhibitors; some proportion is still susceptible to amantadine in contrast to ~100% amantadine resistance among currently circulating seasonal human H1N1 and H3N2 viruses. Continued antiviral susceptibility monitoring of H5N1 viruses is needed to maintain therapeutic approaches for control of disease.

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Section: Discussionmentioning

confidence: 63%

Antiviral resistance among highly pathogenic influenza A (H5N1) viruses isolated worldwide in 2002–2012 shows need for continued monitoring

et al. 2013

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“…The prevalence of oseltamivir resistance among seasonal H1N1 viruses increased to almost 100% during 2009-2010, even in countries where oseltamivir had not been used [8]. Of note, although most oseltamivir-resistant seasonal H1N1 viruses were adamantane-susceptible, a number of seasonal H1N1 viruses resistant to both oseltamivir and adamantanes was detected in 2009 in several countries [9,10].…”

Section: Infection With Influenza Viruses Including Seasonal Avian mentioning

confidence: 99%

Neuraminidase inhibitor resistance in influenza viruses and laboratory testing methods

Nguyen

Fry²,

Gubareva³

2012

Antivir Ther

181

183

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Infection with influenza viruses, including seasonal, avian and pandemic viruses, remains a worldwide public health problem. Although influenza virus infection is both vaccine preventable and drug treatable, high rates of mutation and reassortment of viruses can result in reduced effectiveness of vaccines or drugs. Currently, two classes of drugs, adamantanes (M2 blockers) and neuraminidase (NA) inhibitors (NAIs), are available for treatment and chemoprophylaxis of influenza infections. Given these limited antiviral therapy options, resistance to anti-influenza drugs is a constant concern. The emergence and global spread of adamantane-resistant H3N2 viruses in 2003-2004 and oseltamivir-resistant seasonal H1N1 viruses in 2007-2009 demonstrated the ability of drug-resistant variants to rapidly become predominant worldwide. Since the 2009 H1N1 pandemic, all influenza viruses circulating in humans are M2-blocker-resistant and, in general, NAI-susceptible. However, pandemic H1N1 viruses with resistance to the NAI oseltamivir have been reported. 'Permissive' drift mutations and reassortment of viral gene segments have been proposed as mechanisms underlying the retained replicative fitness of resistant viruses. Nevertheless, the precise role of these genetic changes in the efficient transmission and maintenance of resistant viruses in the absence of drug pressure remains poorly understood. In this review, we summarize NAI resistance in influenza viruses and discuss recent challenges in laboratory testing methods. Close monitoring of antiviral resistance among all influenza viruses, both locally and globally, are essential to inform public health strategies for the control of influenza infections.

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“…10 Some studies have reported the resistance pattern of the H1N1 09 virus to amantadine and oseltamivir. [11][12][13] Rapid detection of such resistance is clinically important in reducing the time between diagnosis and initiation of individualized therapy. Therefore, close monitoring of the prevalence of antiviral resistance and discoveries of drugs and potent vaccines are necessary to control influenza burden.…”

Section: Viral Culturementioning

confidence: 99%

Tools to Detect Influenza Virus

Kim

Poudel

2013

Yonsei Med J

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In 2009, pandemic influenza A (H1N1) virus (H1N1 09) started to spread quickly in many countries. It causes respiratory infection with signs and symptoms of common infectious agents. Thus, clinicians sometimes may miss the H1N1 patient. Clinical laboratory tests are important for the diagnosis of the H1N1 infection. There are several tests available, however, the rapid test and direct fluorescence antigen test are unable to rule out the influenza virus infection and viral culture test is time consuming. Therefore, nucleic acid amplification techniques based on reverse transcription polymerase chain reaction assays are regarded as a specific diagnosis to confirm the influenza virus infection. Although the nucleic acid-based techniques are highly sensitive and specific, the high mutation rate of the influenza RNA-dependent RNA polymerase could limit the utility of the techniques. In addition, their use depends on the availability, cost and throughput of the diagnostic techniques. To overcome these drawbacks, evaluation and development of the techniques should be continued. This review provides an overview of various techniques for specific diagnosis of influenza infection.

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Adamantane- and Oseltamivir-Resistant Seasonal A (H1N1) and Pandemic A (H1N1) 2009 Influenza Viruses in Guangdong, China, during 2008 and 2009

Abstract: Adamantane and oseltamivir resistance among influenza viruses is a major concern to public health officials.

Cited by 13 publications

References 27 publications

Antiviral resistance among highly pathogenic influenza A (H5N1) viruses isolated worldwide in 2002–2012 shows need for continued monitoring

Antiviral resistance among highly pathogenic influenza A (H5N1) viruses isolated worldwide in 2002–2012 shows need for continued monitoring

Neuraminidase inhibitor resistance in influenza viruses and laboratory testing methods

Tools to Detect Influenza Virus

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